CAJ | 학술논문

目的：探讨重症急性胰腺炎（ severe acute pancreatitis，SAP）早期腹腔引流时机及引流方式选择。方法对32例重症急性胰腺炎患者采用B超或CT引导下经皮穿刺置管引流腹腔或胰周积液，同时予以生长抑素、抑酸、抗感染、保持水电解质及酸碱平衡、营养支持等综合治疗。结果32例患者中，3例因后期胰腺感染性坏死，引流管堵塞，行外科手术干预，2例治愈，1例术后因真菌感染死于多器官功能障碍综合征，另有3例置管引流患者死于相关并发症，共28例治愈，总治愈率为87.5％（28/32）；总病死率为12.5％（4/32）；引流时间7~60 d，平均28 d，引流次数1~4次。结论对于重症急性胰腺炎早期腹腔或胰周积液时，腹腔及小网膜囊内置管引流是一种安全有效的治疗方法，对于大部分选择恰当的病例，可以避免传统的手术引流。
목적：탐토중증급성이선염（ severe acute pancreatitis，SAP）조기복강인류시궤급인류방식선택。방법대32례중증급성이선염환자채용B초혹CT인도하경피천자치관인류복강혹이주적액，동시여이생장억소、억산、항감염、보지수전해질급산감평형、영양지지등종합치료。결과32례환자중，3례인후기이선감염성배사，인류관도새，행외과수술간예，2례치유，1례술후인진균감염사우다기관공능장애종합정，령유3례치관인류환자사우상관병발증，공28례치유，총치유솔위87.5％（28/32）；총병사솔위12.5％（4/32）；인류시간7~60 d，평균28 d，인류차수1~4차。결론대우중증급성이선염조기복강혹이주적액시，복강급소망막낭내치관인류시일충안전유효적치료방법，대우대부분선택흡당적병례，가이피면전통적수술인류。
Objective To investigate the timing and method of early peritoneal drainage for se-vere acute pancreatitis( SAP). Methods A total of 32 SAP patients from January 2008 to June 2013 were enrolled. All patients received ultrasound or CT guided percutaneous catheter drainage of peritoneal or peripancreatic fluid collections. Meanwhile,patients were given somatostatin,antacids,antibiotics,maintai-ning water-electrolyte and acid-base balance,nutritional support and other comprehensive treatment. Re-sults In the 32 cases,3 patients received surgical intervention for infectious pancreatic necrosis and cath-eter blockage. Two cases were cured,but 1 patient died of MODS caused by fungal infection. Another 3 pa-tients with drainage died of related complications. A total of 28 patients were cured. The total curative rate was 87. 5%(28/32)and the overall mortality was 12. 5%(4/32). The duration of drainage ranged from 7 to 60 days with an average of 28 days. The times of drainage ranged from 1 to 4 times. Conclusion Percu-taneous catheter drainage of the abdomen and lesser omental bursa is a safe and effective treatment for per-itoneal or peripancreatic fluid collections of SAP. It can avoid the traditional surgical drainage for most se-lected patients.